The top cause of liver disease is fat, and healthcare professionals like Joel Lavine MD are tracking the link between obesity and childhood liver issues.

DEL MAR, CALIFORNIA, June 2022 –  With obesity and, more specifically, fat taking over as the leading cause of chronic liver disease globally, a burgeoning field of medical research is the study of nonalcoholic fatty liver disease or NAFLD. Dr. Joel Lavine has focused his clinical studies on treatment pathways for children with the disease and preventative behaviors.

For many patients, both adults and children, diagnosis may stop at NAFLD, but approximately one-fifth of all diagnosed see a progression to an even more serious disorder known as nonalcoholic steatohepatitis or NASH. NASH can lead to cirrhosis and liver cancer. It is also a primary cause of liver transplants.

This makes prevention strategies designed to help children and adolescents avoid NALFD and NASH extremely important. After a diagnosis, effective treatment can help avoid the escalation of the disease.

Joel Lavine on NALFD causes

While excess weight and fat are the major reasons for the increase of NALFD, food intake adjustments and calorie reduction alone are not the sole issue, according to Joel Lavine, Columbia professor.

In a Columbia Medicine article focused on NALFD, Lavine explained excess calories are a problem, but an alternate and related issue is the type of foods consumed. Lavine clarified that a diet low in fruit and vegetable consumption limits the intake of antioxidants that are essential for a healthy liver. A lack of antioxidants in the diet can lead to greater oxidative stress in the liver and more damaged cells.

Damaged cells can be viewed as the first domino fall in a cascade of issues that culminate in the production of cirrhotic nodules.

Children with fatty livers

In his career, Lavine has witnessed children as young as 2 with fatty livers and with cirrhosis by age 8.

While children can be more responsive to lifestyle change, according to Dr. Joel Lavine, they rarely have the agency to implement broader lifestyle changes key to prevention and treatment, such as choosing healthier foods and meals when grocery shopping.

Instead, parents and the entire family need to work as a unit to develop healthy eating habits, such as incorporating foods rich in antioxidants into the diet and embracing a more active lifestyle.

Lavine also recommends specific vitamins to help patients combat NASH. In controlled trials, Lavine and colleagues found Vitamin E helped with NASH resolution for both children and adults. Additional studies and publications associated with the discovery have led to Vitamin E becoming part of basic treatment guidelines for individuals diagnosed with NASH.

Outside of supplementation with vitamins, many NAFLD and NASH treatments remain in the theoretical stage due to limited clinical trials for pharmaceuticals designed for children with NASH. Some prescription medications with positive results for adult patients have not been tested with younger patients and are not approved for childhood or adolescent use.

With the increase in patients diagnosed with NAFLD and NASH, Joel Lavine MD remains optimistic more pharmaceuticals and diagnostic tests for the diseases will be developed to combat the increased need.